New Study Backs Fortifying Cereals with Iron

Cereals in poor countries could be fortified with a new form of iron to help roll back anemia, an investigation published in the Lancet suggests.

Nearly half of young children in developing countries suffer from iron deficiency, caused mainly by a diet based overwhelmingly on rice, maize (also known as corn) and other grains.

Cereals contain phytates, which bind tightly to the form of iron found in plant food and prevent it from being broken down in the intestine. As a result, the body absorbs only five percent of all iron in plant food, and the rest is excreted.

Dozens of countries today reinforce their cereals with iron in a bid to tackle anemia. The iron is usually pure iron powder derived electrolytically from mineral iron sulphate.

But the new study says that electrostatic iron is ineffective. It may be cheap, but it too binds to the bothersome phytates.

The authors, led by Pauline Andang’o, a nutritionist at Wageningen University in the Netherlands, tested a new form of iron among schoolchildren in Kenya.

Called sodium iron edetic acid (NaFeEDTA), the iron comprises particles wrapped in a carbon-compound “jacket” to prevent it from being snared by the phytates, thus boosting the chances of delivering it intact to the gut.

The researchers trialed the new coating among 505 young children aged three to eight at Marafa, eastern Kenya.

All of the children ate uji, a local porridge made from whole maize flour and sweetened with sugar, every day for five months.

One group had uji without iron fortification, to act as a comparison, or “control” group; the second was given porridge with electrolytic iron, in line with the dosage recommendations of the South African government; the third was given the new “iron-EDTA” at two dosage levels.

At the end of the experiment, fortification with iron-EDTA reduced prevalence of anemia by 89 percent as compared to the control group, while the electrolytic iron had no effect at all on anemia prevention.

Children who had low iron levels benefited most from the EDTA addition. But children who already had relatively good iron levels did not appear to suffer harm from eating the fortified cereals. Five children had more than the acceptable daily intake of iron, but there were no known ill effects.

The study, which appears in a peer-reviewed journal, was funded by the food giant Unilever and the chemical form Akzo Nobel Chemicals, which developed the iron-EDTA.

In a commentary, also published by The Lancet, US expert Ted Greiner said the findings “turn the tide” in the debate about nutritional addition for poor people, providing crucial early evidence that fortification could yield results.

“It is time to fortify the world’s processed cereal foods,” he said.

In 1990, only the United States and Canada reinforced their flour with iron; today, 49 countries do, including Nigeria and South Africa, Wageningen said in a press release.

Iron deficiency is acute among children in sub-Saharan Africa, where the typical diet is wholegrain flour, which has a much higher content of phytates than white flour.

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