Effects of wheat flour fortified with different iron fortificants on iron status and anemia prevalence in iron deficient anemic students in Northern China.
OBJECTIVE
To compare the effects of wheat flours fortified with NaFeEDTA, FeSO4 and elemental iron (electrolytic iron), in improving iron status in anemic students.


METHODS
Four hundreds anemic students (11 to 18 years old) were divided into four groups and given wheat flour fortified with different iron fortificants at different concentrations: control group (no added iron); NaFeEDTA group (20 mg Fe/kg); FeSO4 group (30 mg Fe/kg); and elemental iron group (60 mg Fe/kg). The trial lasted for 6 months and the following parameters were examined every 2 months: whole blood hemoglobin, free erythrocyte protoporphyrin, serum ferritin, serum iron, total iron binding capacity and transferrin receptor.


RESULTS
The flour consumption in the 4 groups was 300-400 g/person/day, accounted for 70% of total cereal consumption in the diets. There were no significant differences in flour consumption among the 4 groups. Blood hemoglobin level increased in all the 3 intervened groups, but the increment in the NaFeEDTA group was significantly higher and earlier than the other 2 groups; and only 1% of the subjected remained anemic at the end of the trial in the NaFeEDTA group, while 40% and 60% of the subjects in the FeSO4 and electrolytic iron group remained anemic, respectively. The order of improvements in free erythrocyte protoporphyrin, serum ferritin and transferring receptor levels were: NaFeEDTA > FeSO4 > electrolytic iron. No significant changes were found in the control group on all the tested parameters during the trial.


CONCLUSIONS
The results indicated that even NaFeEDTA was added at a lower level, it has better effects than FeSO4 and elemental iron on controlling iron deficiency anemia and improving iron status in anemic children; while elemental iron was the least effective.
Sun
Jing
J
Institute of Nutrition and Food Safety, Chinese Center for Disease Control and Prevention, 29 Nan Wei Road, Beijing 100050, China.
Huang
Jian
J
Li
Wenxian
W
Wang
Lijuan
L
Wang
Anxu
A
Huo
Junsheng
J
Chen
Junshi
J
Chen
Chunming
C
D000293:Adolescent; D017195:Adolescent Nutritional Physiological Phenomena; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000453:epidemiology*; D002648:Child; D002681:China / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D004492:Edetic Acid; D005260:Female; D005290:Ferric Compounds / Q000032:analysis / Q000627:therapeutic use*; D005293:Ferritins / Q000097:blood; D005433:Flour; D005527:Food, Fortified; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007501:Iron / Q000097:blood*; D019266:Iron, Dietary / Q000032:analysis / Q000627:therapeutic use*; D008297:Male; D009752:Nutritional Status; D011990:Receptors, Transferrin / Q000378:metabolism; D016896:Treatment Outcome; D014908:Triticum / Q000737:chemistry
D005290:Ferric Compounds; D006454:Hemoglobins; D019266:Iron, Dietary; D011990:Receptors, Transferrin; D005293:Ferritins; D004492:Edetic Acid; D007501:Iron; C019179:Fe(III)-EDTA