title: Extruded rice fortified with micronized ground ferric pyrophosphate reduces iron deficiency in Indian schoolchildren: a double-blind randomized controlled trial.
abstract: BACKGROUND
  Iron fortification of rice could be an effective strategy for reducing iron deficiency anemia in South Asia.
  
  
  OBJECTIVE
  We aimed to determine whether extruded rice grains fortified with micronized ground ferric pyrophosphate (MGFP) would increase body iron stores in children.
  
  
  METHODS
  In a double-blind, 7-mo, school-based feeding trial in Bangalore, India, iron-depleted, 6-13-y-old children (n = 184) were randomly assigned to receive either a rice-based lunch meal fortified with 20 mg Fe as MGFP or an identical but unfortified control meal. The meals were consumed under direct supervision, and daily leftovers were weighed. All children were dewormed at baseline and at 3.5 mo. Iron status and hemoglobin were measured at baseline, 3.5 mo, and 7 mo.
  
  
  RESULTS
  At baseline, the prevalences of iron deficiency and iron deficiency anemia in the total sample were 78% and 29%, respectively. After 7 mo of feeding, there was a significant increase in body iron stores in both study groups (P < 0.001), with a greater increase in the iron group than in the control group (P < 0.05). There was a significant time x treatment interaction for iron deficiency, which fell from 78% to 25% in the dewormed iron group and from 79% to 49% in the dewormed control group. Iron deficiency anemia decreased from 30% to 15% (NS) in the iron group but remained virtually unchanged in the control group (28% and 27%). In sensory tests, the MGFP-fortified rice (fortified at 3 and 5 mg Fe/100 g) was indistinguishable from natural rice, in both cooked and uncooked form.
  
  
  CONCLUSIONS
  Extruded rice fortified with MGFP has excellent sensory characteristics. Fed in a school lunch meal, it increases iron stores and reduces the prevalence of iron deficiency in Indian children.
authors.affiliation: Human Nutrition Laboratory, Institute of Food Science and Nutrition, Swiss Federal Institute of Technology, Zurich, Switzerland.
authors.forename: Diego
authors.initials: D
authors.lastname: Moretti
authors.forename: Michael B
authors.initials: MB
authors.lastname: Zimmermann
authors.forename: Sumithra
authors.initials: S
authors.lastname: Muthayya
authors.forename: Prashanth
authors.initials: P
authors.lastname: Thankachan
authors.forename: Tung-Ching
authors.initials: TC
authors.lastname: Lee
authors.forename: Anura V
authors.initials: AV
authors.lastname: Kurpad
authors.forename: Richard F
authors.initials: RF
authors.lastname: Hurrell
mesh_terms: D000293:Adolescent; D018798:Anemia, Iron-Deficiency / Q000178:diet therapy*; D001682:Biological Availability; D002648:Child; D011756:Diphosphates / Q000008:administration & dosage* / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D005522:Food Services; D005527:Food, Fortified; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007194:India; D007501:Iron / Q000008:administration & dosage* / Q000494:pharmacology*; D008297:Male; D012275:Oryza; D012572:School Health Services
chemical_list: D011756:Diphosphates; D006454:Hemoglobins; D007501:Iron; C049051:ferric pyrophosphate